A Remarkable Increase in Total Homocysteine Concentrations in the CSF of Migraine Patients With Aura

Objective.- To investigate whether total and free homocysteine (HC) levels are increased in the cerebrospinal fluid (CSF) of patients with migraine headache compared with normal control populations. Methods.- The concentrations of free and total HC in the CSF of migraine without aura (MOA) and migraine with aura (MWA) patients were determined. Results.- The concentration of free HC did not differ significantly from normal controls, but the total HC concentration was significantly higher in MOA and MWA patients (41% increase in MOA, P < .001 and 376% increase in MWA, P < .0001) in the mean of the confidence interval of each groups compared with normal controls). Conclusions.- These findings suggest that an increase of total HC concentration in the brain is commonly seen in migraine patient and is particularly pronounced in MWA sufferers. We speculate that total HC not only contribute to the development of atherosclerotic conditions, including cardiocerebrovascular diseases, but also reflects an epiphenomenon.